Exposures to synthetic cathinones, fentanyl, and xylazine among nightclub attendees in New York City, 2024

Background

Use of party drugs is common among nightclub attendees, but more information is needed regarding both intentional use and unknown exposure to synthetic cathinones, fentanyl, and xylazine in this high-risk population.

Methods

Throughout 2024, participants attending nightclubs in New York City were surveyed and had their saliva analyzed for drug exposure using targeted and untargeted analysis (n = 1024). We calculated the prevalence of synthetic cathinone, fentanyl, and xylazine exposure overall and in relation to demographic and drug use characteristics.

Results

11 (1.1 %) tested positive for one or more synthetic cathinones, 1.5 % (n = 15) tested positive for fentanyl or its precursor (4-ANPP), and 4 (0.4 %) tested positive for xylazine. All but one exposure to fentanyl was linked to unreported past-month use (93.3 %) and 54.5 % of synthetic cathinone exposures were linked to unreported past-month use (ps<.05). Three of four participants (75.0 %) testing positive for xylazine also tested positive for fentanyl exposure. Most (n = 8) synthetic cathinone exposures involved methylmethcathinone (MMC), and there were also detections of chloromethcathinone (CMC, n = 4), N-N-dimethylpentylone (n = 2), N-ethylpentylone (n = 2), and eutylone (n = 2). Compared to those testing positive for synthetic cathinones, those testing positive for fentanyl were more likely to identify as heterosexual and/or test positive for prescription opioid use, and less likely to have a college degree or to test positive for MDMA use (ps<.05).

Conclusions

Unintentional exposure to these drugs is occurring, often because they have been added as adulterants in more common drugs. Results can inform prevention and harm reduction education in this population and in the general population.